DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Sampson, Michael David	DOIID	599212	NAIC NPN	8292906

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	12/1/2004	2/28/2010
Inactive	Non Resident	Agent	Property	12/1/2004	2/28/2010
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Progressive Direct Insurance Company	301379	Agent - Casualty	1/14/2005	4/18/2008
Inactive	Progressive Direct Insurance Company	301379	Agent - Property	1/14/2005	4/18/2008
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	1/14/2005	4/18/2008
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	1/14/2005	4/18/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Property	7/31/2007	4/8/2008
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Casualty	7/31/2007	4/8/2008